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Emotional and sexual abuse were directly associated with CS. Based on the Interpersonal Psychological Theory of Suicide, the result for emotional abuse was surprising and raised the question for a missing link in this association. Consequently, this study examines nonsuicidal self\u2010injury (NSSI) as an additional mediator (<jats:italic>M<\/jats:italic><jats:sub>1<\/jats:sub>) between child abuse (<jats:italic>X<\/jats:italic>), pain tolerance (<jats:italic>M<\/jats:italic><jats:sub>2<\/jats:sub>), and suicide attempts (<jats:italic>Y<\/jats:italic>). We included 308 psychiatric inpatients (<jats:italic>M<\/jats:italic> = 36.9 years, 53% female) with either an acute suicidal crisis (<jats:italic>n<\/jats:italic> = 146) or a recent suicide attempt (<jats:italic>n<\/jats:italic> = 157). For the assessment, we used the Childhood Trauma Screener (CTS), the German version of the self\u2010injurious thoughts and behaviours interview (SITBI\u2010G), the German Capability for Suicide Questionnaire (GCSQ), and a pressure algometer for measuring pain tolerance objectively. Serial mediator analyses were applied. All types of abuse showed relationships with NSSI, which itself was connected to suicidal behaviour in almost all models, whereas pain tolerance did not show the expected relations. The results suggest that NSSI is an important predictor for suicide attempts and should be considered in suicide risk assessment. Future research should address this topic in prospective studies with a more comprehensive assessment of child abuse. In summary, this study once again highlights the serious effects of child abuse and in particular the mediating role of NSSI.<\/jats:p>","DOI":"10.1002\/cpp.2501","type":"journal-article","created":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T16:25:07Z","timestamp":1597940707000},"page":"189-199","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Is the relationship between child abuse and suicide attempts mediated by nonsuicidal self\u2010injury and pain tolerance?"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2009-0512","authenticated-orcid":false,"given":"Antje","family":"Sch\u00f6nfelder","sequence":"first","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology University of Leipzig  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dajana","family":"Rath","sequence":"additional","affiliation":[{"name":"Institute of Medical Psychology and Medical Sociology University Hospital of RWTH Aachen University  Aachen Germany"},{"name":"Department of Clinical Psychology, Institute of Psychology University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Forkmann","sequence":"additional","affiliation":[{"name":"Institute of Medical Psychology and Medical Sociology University Hospital of RWTH Aachen University  Aachen Germany"},{"name":"Department of Clinical Psychology, Institute of Psychology University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Paashaus","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy Ruhr\u2010University Bochum  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarina","family":"Stengler","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Psychosomatic Medicine and Psychotherapy Helios Park Hospital Leipzig  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6498-7356","authenticated-orcid":false,"given":"Tobias","family":"Teismann","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy Ruhr\u2010University Bochum  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Juckel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, LWL\u2010University Hospital Ruhr\u2010University Bochum  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heide","family":"Glaesmer","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology University of Leipzig  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10926771.2017.1350773"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2013.03.013"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.07.023"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2134(02)00541-0"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.113.1.82"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.107.037994"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.11.1871"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1754-3"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004644"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000000502"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2004.01.008"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1037\/t05142-000"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000084"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1521\/suli.31.4.405.22042"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1343116"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22650"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1298984"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2010.04.009"},{"key":"e_1_2_10_20_1","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis","author":"Hayes A. 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